AANP Family Nurse Practitioner (FNP) Certification ExamEvaluationMedium
A 35-year-old female with a history of anaphylaxis to peanuts is prescribed a new medication. The FNP is providing education on recognizing and responding to a severe allergic reaction. Which of the following is an early sign of anaphylaxis that requires immediate epinephrine administration?
- AMild abdominal cramping and nausea.
- BLocalized itching at the site of injection.
- CGeneralized urticaria and pruritus.
- DRhinorrhea and sneezing.
Show answer & explanationAnswer & explanation
Correct answer: C. Generalized urticaria and pruritus.
Generalized urticaria and pruritus (hives and itching) are common and often early cutaneous manifestations of anaphylaxis, indicating a systemic reaction that warrants immediate epinephrine administration, especially in a patient with a history of anaphylaxis.
Why the other options are wrong
- A. Mild abdominal cramping and nausea can be symptoms of anaphylaxis but are often preceded or accompanied by more distinct cutaneous or respiratory symptoms. They are not as specific for early, immediate intervention as widespread hives.
- B. Localized itching at an injection site is a localized reaction, not indicative of systemic anaphylaxis.
- D. Rhinorrhea and sneezing are symptoms of allergic rhinitis, not typically signs of anaphylaxis unless accompanied by other severe symptoms.
Anaphylaxis Recognition
Anaphylaxis is a severe, life-threatening systemic allergic reaction characterized by rapid onset of symptoms involving multiple organ systems, most commonly skin, respiratory, gastrointestinal, and cardiovascular.
- Early recognition is crucial for effective treatment.
- Skin symptoms (hives, itching, flushing) are present in 80-90% of cases.
- Epinephrine is the first-line treatment and should be administered immediately.
Memory trick: Hives, wheezing, low pressure, swelling fast, means give epi, make it last!